Liara Micaela Tillman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1487984431 Issued in IL

Practice address

9697 191St St
Mokena, IL 60448-8609

Phone

(630) 305-5027

NPI assigned

Jan 13, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Liara Micaela Leftridge Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lleftridge179628@direct.edward.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912

  IL

  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  IL

  Medicare reassignment NPD
• Edward Health Ventures

  • Neurological Surgery Physician
  • Naperville, IL
  • NPI 1396976445
  NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Integrity Clinical Consulting & Training LLC

  • Clinical Social Worker
  • Homewood, IL
  • NPI 1043612443

  Clinical

  NPD (past)
• Naperville Psychiatric Ventures

  • Psychiatric Hospital
  • Naperville, IL
  • NPI 1619910460
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1487984431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9697 191ST ST",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488609",
            "telephone_number": "630-305-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9697 191ST ST",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488609",
            "telephone_number": "630-305-5027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Ridge Rd",
            "address_2": "Suite 1SW",
            "address_purpose": "LOCATION",
            "city": "Homewood",
            "state": "IL",
            "postal_code": "604301933",
            "country_code": "US",
            "telephone_number": "708-794-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "LIARA",
        "middle_name": "MICAELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "1487984431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lleftridge179628@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9697 191st St",
            "city": "Mokena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604488609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LIARA",
            "last_name": "LEFTRIDGE",
            "middle_name": "MICAELA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Mokena, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.